England has become the "poor relation" to Scotland in healthcare, it was claimed yesterday, with devolution creating four distinct health services across the UK whose differences are set to increase over time.

England has become the "poor relation" to Scotland in healthcare, it was claimed yesterday, with devolution creating four distinct health services across the UK whose differences are set to increase over time.

As 2008 marks the 60th anniversary of the creation of the NHS, Michael Summers, vice-chairman of the Patients Association, a UK-wide charity aimed at helping people share their experiences of healthcare, said: "We should follow best practice ... which they have discovered in Scotland, Wales and Northern Ireland.

"They have all said that people should have free prescriptions and that we should look after our elderly people. England, for some reason, seems to have been the poor relation."

Gill Morgan of the NHS Confederation, another charity which represents NHS organisations, said: "We basically have four different systems albeit with the same set of values.

"This period since devolution has been unique in the history of the NHS as it was essentially the same across the UK before devolution. We have had a complete split in philosophy," she said.

Dr Morgan explained that while England had concentrated on cutting waiting times and offering patients more choice, Scotland had focused less on reducing waiting times but had given a commitment on free personal care, which is means-tested elsewhere in the UK.

Wales, meantime, had introduced free prescriptions while Northern Ireland had seen more integration between health and social care.

Dr Morgan stressed that it was too early to say which system was more successful as each had its advantages.

"It is a necessary consequence of devolution because health is such an important part of every country's portfolio of services that government has a responsibility for providing," she said. "Any good government is going to look at the needs and particular circumstances of its own population to design services that are right for the population it serves."

In 2005, the British Medical Journal reviewed the impact of devolution on healthcare. While it showed that waiting times in England had fallen the most, it also discovered that in terms of public spending England had the lowest level; Scotland had the highest.

Between 1997 and 2003, health spending per capita had risen from £831 to £1085 south of the border while it had risen from £1047 to £1262 north of the border.

Last night, a Scottish Government spokesman told The Herald that Scotland's distinct geography and demography required a discrete approach to delivering healthcare.

"Ministers are committed to taking radical and sustained action to tackle widening health inequalities, focused on the particular challenges facing Scotland's most disadvantaged communities, such as smoking, alcohol misuse and obesity and poor diets," he said.

This, insisted the spokesman, was the Scottish Government's top health priority. The Ministerial Task Force on Health Inequalities, led by Shona Robison, Scotland's Minister for Public Health, would report to the Holyrood Cabinet by May 2008 on a range of cross-governmental recommendations to tackle the most significant and widening health inequalities.

"However, we are already committed to abolishing prescription charges by April 2011, developing new approaches to anticipatory care and introducing Life Begins' health checks and rolling out simple but effective interventions to promote good health in acute hospitals," said the spokesman.

For Labour, Margaret Curran emphasised how Scotland's NHS had made "considerable strides"

under the previous Labour administration.

She said: "In recent years, health spending per head in Scotland has been higher than in England. However, funds available to NHS England will rise by an average annual real terms amount of 4% in the three years to 2011.

"Over the same period, the Scottish Government will devote on average a 1.5% annual real terms increase to its health portfolio."